Individual provider Active NPI

Heidi Mae Daugherty, CNP

  • Adult Health Nurse Practitioner
  • Canton, OH
National Provider Identifier
1346497906
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP-10102 Issued in OH
Practice address
4565 Dressler Rd NW
Suite 111
Canton, OH 44718-2549
Phone
(330) 493-0013
Fax
(330) 493-6973
NPI assigned
Aug 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP-10102 OH Primary

Addresses

Primary practice location

4565 Dressler Rd NW
Suite 111
Canton, OH 44718-2549

Mailing address

4565 Dressler Rd NW
Suite 111
Canton, OH 44718-2549
Phone (330) 493-0013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140226001702 OH Practitioner - Nurse Practitioner 6103056775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4565 Dressler Rd NW
Suite 111
Canton, OH 44718-2576
Phone (330) 493-0013

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084
  • Alliance Community Hospital Hospital, Alliance, OH, CCN 360131
  • Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323
  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Pomerene Hospital Hospital, Millersburg, OH, CCN 360148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-10102OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes & Endocrinology Associates of Stark County Incorporated CurrentSince Dec 28, 2013 Accepting new patients

Locations

4565 Dressler Rd NW
Ste 111
Canton, OH 44718
Phone (216) 493-0013

Interoperability endpoints

  • Direct secure messaging: drh.daugherty@endocrine.medentdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1346497906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4565 DRESSLER RD NW",
            "address_2": "SUITE 111",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182549",
            "telephone_number": "330-493-0013",
            "fax_number": "330-493-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 DRESSLER RD NW",
            "address_2": "SUITE 111",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182549",
            "telephone_number": "330-493-0013",
            "fax_number": "330-493-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "HEIDI",
        "middle_name": "MAE",
        "name_prefix": "Miss",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP-10102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.